Saturday, April 20, 2024

Heart of the matter


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At 27, Lisa Oxley had been living her dream. She had just graduated from medical school in July 2012, an achievement she had wanted since growing up, and was doing her internship at the beginning of the year at Mount St John Medical Centre in Antigua. So for her, her world was at its peak.
Then suddenly her whole world started to fall apart.
“On the first of May I was on one of my scheduled ward rounds and then I came down with chest pains, shortness of breath and profuse sweating,” she recalled.
“My colleagues ran some tests and admitted me.”
Throughout that process Lisa kept telling herself she was fine.
“When I was admitted, they thought I was having a blood clot to my lungs, a pulmonary embolism, but that was ruled out,” she said.
“Then one night while admitted, I started to have chest pains again and an echocardiogram was done and that was the first abnormal one, but although it was abnormal. it wasn’t saying much. Every possible diagnosis, including lupus, that was thought about was ruled out.”
Lisa eventually called her mother in Barbados and told her what was happening and she was in Antigua the next day. It was her mother who persuaded Lisa to return to Barbados to get a second opinion.
“I called a couple of cardiologists, and one of them eventually took my case,” Lisa revealed.
“The doctor thought because of my age it was gastro-oesophageal reflux disease (GERD) or anxiety but he decided to run some tests.
“My electrocardiogram was normal, but the only thing that was slightly abnormal was my heart rate. Another echocardiogram was quite abnormal. As soon as he said that, I braced myself for the news. He told me I had micro-valve prolapse, a hole in my heart, and both coronary arteries they saw on the echocardiogram were twice their size.
You’re not supposed to see coronary arteries on an echocardiogram. It also showed that my right coronary artery was out of place.”
What followed then was a number of questions about her childhood, which she revealed was relatively normal. She had typical colds but was an active child with no major illnesses. Nor did she get tired when playing with other children.
“We needed to do a computerized tomography (CT) coronary angiogram to further see where the right coronary artery was originating from and why my coronary arteries are so enlarged,” she said.
In an effort to return some normalcy to her life after the tests, Lisa returned to Antigua and attempted to resume her internship, but her chest pains resumed, along with the shortness of breath and profuse sweating continually, and she couldn’t climb a flight of stairs or walk the corridor, so doing her job became impossible. Lisa then had to suspend her internship and try to get treatment for this condition.
“In early June I was back in Barbados to do the CT coronary which was very interesting. My right coronary artery should come from my aorta; however, when I took it, it was coming from my pulmonary artery,” she said.
“When they did eventually diagnose the condition, it was anomalous origin of the right coronary artery from the pulmonary artery.
“The tests also showed that the coronary arteries were very dilated and tortuous and they’re supposed to be straight, and they are like that because they’re overworked trying to supply my heart with the adequate quantity of blood.
“So my heart is receiving its main blood supply from my left coronary artery. That’s how my heart compensated for it. The tests also showed my heart decided to remodel and produce vessels so that it could compensate for the supply on the right side. The condition, which is extremely rare, can only be corrected by open heart surgery to re-implant the right coronary artery.   
At this time Lisa is trying to get US$30 000 together to have the surgery in October. She is receiving help from the old scholars’ association at her old school, Ellerslie Secondary, which is raising funds on her behalf. While her mother has been traumatized by the diagnosis, Lisa said the whole experience has raised her faith and belief in God.
“I look at this time in my life as having an experience from both ends of the spectrum, that of being a doctor and a patient,” she said.
“It made me understand what my patients go through because I wasn’t diagnosed with a common condition or disease, I was diagnosed with something very rare. Even my cardiologist admitted that he had never seen it.”
The condition is congenital and not genetic.
Lisa who is planning to write a book about this experience, says it has helped her determine what she wants to specialize in as a doctor, which is cardiology and a subspecialty in paediatric cardiology.
“I am a very determined person and I don’t like to quit,” she says of her condition.
“I’m a fighter.”
Lisa said that during this process she never lost faith in God.
“I didn’t question God because this is a condition that I have lived with for 27 years and it made me appreciate God more,” Lisa said.
“Not only did I have this birth defect but when my body realized it, nature took its course to compensate. So I never questioned it because I know He still has plans for me.”


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